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Parent participation during burn debridement in relation to behavioral distress
C E Foertsch1, M W O'Hara, F J Stoddard
1Department of Psychology, New York Hospital-Cornell Medical Center, White Plains, NY 10605, USA.
Insights
Parent presence during pediatric procedures may increase child distress. This study found higher behavioral distress when parents were present versus absent during burn dressing changes, challenging common recommendations.
Area of Science:
- Pediatric Psychology
- Child Health Research
- Medical Procedure Outcomes
Background:
- Parental presence during pediatric medical procedures is widely recommended.
- However, evidence supporting its effectiveness in reducing child distress is mixed.
- The impact of parental involvement on children's behavioral distress requires further investigation.
Purpose of the Study:
- To examine the effect of parent presence on behavioral distress in children undergoing burn dressing changes.
- To assess the level and nature of parent participation during these procedures.
- To compare distress levels with and without parental presence.
Main Methods:
- A sample of children aged 3-12 years undergoing successive burn dressing changes.
- Parental presence was varied across sessions (present vs. absent).
- Behavioral distress was measured using a validated scale; parent participation was informally assessed.
Main Results:
- No significant differences were found in participation levels between mothers and fathers.
- Parental participation levels remained consistent across repeated procedures.
- Children exhibited higher levels of behavioral distress when parents were present compared to when they were absent.
Conclusions:
- Parental presence alone may not reduce, and could potentially increase, behavioral distress during pediatric procedures.
- Findings suggest a need to re-evaluate current recommendations for parental involvement.
- Further research into effective parent coaching strategies is warranted.
Abstract:
The data on the benefits of parent participation during pediatric medical procedures are mixed. Although a wealth of clinical experience and survey data strongly recommend parent participation in a child's medical care, the mere presence of a parent, particularly during medical procedures, may be insufficient to decrease behavioral distress. This study examined a sample of children aged 3 through 12 undergoing three successive burn dressing changes. For some sessions, parents were present, and for others, they were not. A valid and reliable measure of behavioral distress was taken, as was an informal measure of the level of parent participation. Results indicated no differences between mothers and fathers in the level or the nature of participation, little change in the level of participation across time, and higher levels of physical comforting than verbal comforting. Results also indicated higher levels of behavioral distress in subjects when parents were present versus when absent, which extends previous findings. Results are discussed in terms of the literature on parent and child preferences for parent involvement and parent coaching programs.